The Relation Between Chlamydia Pneu1noniae Infection and Other Risk Factors In Patients With Coronary Heart Disease

Abstract

Cardiovascular disease (CVD) has emerged as the dominant chronic disease in many parts of the world and early in the 2151 century, it is predicted to become the main cause of disability and death worldwide (I).

Many Western countries documented a rise in mortality from CVD until thel960 and 1970s with substantial declines since those peaks. Other parts of the world have shown different patterns including high rates of CVD mortality in Eastern Europe that continue to rise and an ominous epidemic of CHD and stroke emerging in developing countries <2>.

At the beginning of the 20th century, CVD accounted for less than 10% of all deaths worldwide, while at the beginning of the 2151 century, CVD accounts for nearly half of all deaths in the developed world and 25% in the developing world (J, 4> . This global raise in CVD is a result of a dramatic shift in the health status of individuals around the world during the course of the 20th century (I).

By 2020, CVD is predicted to be the number one cause of death accounting for 36% of all deaths, whereas communicable diseases will account for nearly halfthat, at 15% <4>.

In the developing economics an estimated nine million persons died of CVD in 1990, by 2020 that figure will be more than double to more than 18 million persons. annually, accounting for approximately three fourths of CVD deaths worldwide (I).

CVD accounts for higher than 35% in ClllNA, 24% in INDIA, 10% in SUB­ SAHARAN AFRICA, 31% in LATIN AMERICA and CARIBBEAN ,of all total deaths. In MIDDLE EAST CRESCENT, the rate of mortality from CVD is increasing rapidly, and CVD is now the leading cause of death accounting for 25-45 % of total deaths (1). For the UNITED STATES, CHD mortality rate still seems to be declining, but at the slower rate than from 1970 to 1990 (2).

Aetiology of Ischemic Heart Disease (IIID)

The coronary circulation supplies the heart with oxygen and nutrients to maintain cardiac function and thus supply the remainder of the body with blood. Imbalance in myocardial oxygen demand and supply can produce myocardial ischemia with contractile cardiac dysfunction, arrhythmias, infarction, and possibly death <S>.

The most common serious cause of acute chest discomfort is myocardial ischemia or infarction. The classic manifestation of ischemia is angina, which is usually described as a heavy chest pressure or squeezing, a "burning" feeling, or difficulty in breathing<6>.

In a typical population of patients presenting with acute chest pain in emergency departments, there are about 20 % have acute myocardial infarction or unstable angina (7).

Coronary Atherosclerosis

The term "atherosclerosis" is derived from Greek 'athero' (gruel or porridge) and 'sclerosis' (hardening). Many lesion of atherosclerosis are dense and fibrous, whereas others may contain large amounts of lipid and necrotic fibers, with most demonstrating